Provider Demographics
NPI:1982601811
Name:LANDS, RONALD HERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:HERMAN
Last Name:LANDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT 888224
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37995-8224
Mailing Address - Country:US
Mailing Address - Phone:865-305-9340
Mailing Address - Fax:865-305-9144
Practice Address - Street 1:1924 ALCOA HWY # U114
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-305-9340
Practice Address - Fax:865-305-9144
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD011105207RH0003X, 207RG0300X, 207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA99416Medicare UPIN
TN30303362Medicare PIN
TN30303361Medicare PIN
TN30303372Medicare PIN